Previous nonsurgical treatment of myopia using optical and pharmaceutical agents has not allowed an unequivocal consensus. Such studies must be based on the natural history of myopia progression, accurate biometric measurements, and randomized clinical trials. Progress in the research of mechanisms responsible for myopia induction and progression has led to renewed enthusiasm in the optical approach and especially the pharmacological approach. Past experience with the cycloplegics is reviewed. A promising therapeutic agent may be a muscarinic receptor antagonist but without mydriatic and cycloplegic side effects. Retardation and reversal of myopia is important not only for the control of myopia and related complications but for refractive surgery in that low degrees of myopia ensures surgical success and patient satisfaction.